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https://www.readbyqxmd.com/read/29324529/inappropriately-timed-pediatric-orthopaedic-referrals-from-the-emergency-department-result-in-unnecessary-appointments-and-financial-burden-for-patients
#1
Taylor J Jackson, Todd J Blumberg, Apurva S Shah, Wudbhav N Sankar
BACKGROUND: Musculoskeletal injuries are among the most common reasons for emergency department (ED) visits in the pediatric population. Many such injuries can be managed with a single follow-up outpatient visit. However, untimely (ie, premature) referrals by emergency physicians to orthopaedic surgeons are common and may inadvertently create need for a second visit, generating unnecessary expenditures. We sought to elucidate the cost of premature musculoskeletal follow-up visits to the patients, families, and the health care system...
January 10, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29316903/parental-reassurance-concerning-a-feverish-child-determinant-factors-in-rural-general-practice
#2
Anthony Chapron, Marc Brochard, Chloé Rousseau, Anne-Charlotte Rousseau, Martine Brujean, Laure Fiquet, Virginie Gandemer
BACKGROUND: Acute fever is the most common pediatric condition encountered in general practice and a source of parental concern that can result in inappropriate behavior. The main objective of this study was to describe and quantify parental reassurance concerning their feverish child in the context of visits to rural general practitioners (GPs). METHOD: The study included the parents of 202 feverish children, aged from 3 months to 6 years, consulting 13 representative rural GPs...
January 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29279789/asthma-screening-in-pediatric-sickle-cell-disease-a-clinic-based-program-using-questionnaires-and-spirometry
#3
Sara C Sadreameli, Rachel O Alade, Peter J Mogayzel, Sharon McGrath-Morrow, John J Strouse
A clinician diagnosis of asthma is associated with increased morbidity and mortality in people with sickle cell disease (SCD). We hypothesized that a screening program would help identify children with asthma needing referral to pulmonary clinic. We conducted a single-center project to screen patients with SCD for asthma using a previously validated questionnaire (Breathmobile) and for pulmonary function abnormalities with portable spirometry. Participants with a positive questionnaire and/or abnormal spirometry were referred to pediatric pulmonary clinic...
December 1, 2017: Pediatric Allergy, Immunology, and Pulmonology
https://www.readbyqxmd.com/read/29277463/impact-of-implementation-of-electronically-transmitted-referrals-on-pediatric-subspecialty-visit-attendance
#4
Kristin N Ray, Michael Drnach, Ateev Mehrotra, Srinivasan Suresh, Steven G Docimo
OBJECTIVE: One barrier to timely access to outpatient pediatric subspecialty care is the complexity of scheduling processes. We evaluated the impact of implementing electronically-transmitted referrals on subspecialty visit attendance. METHODS: Through collaboration with stakeholders, an electronically-transmitted referral order system was designed, piloted, and implemented in 15 general pediatrics practices, with 24 additional practices serving as controls. We used statistical process control methods and difference-in-differences analysis to examine visits attended, appointments scheduled, appointment non-attendance, and referral volume...
December 22, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29260390/parent-perspectives-and-preferences-for-strategies-regarding-nonsedated-mri-scans-in-a-pediatric-oncology-population
#5
Breya Walker, Heather M Conklin, Doralina L Anghelescu, Lacey P Hall, Wilburn E Reddick, Robert Ogg, Lisa M Jacola
PURPOSE: Children with cancer frequently require MRI scans for clinical purposes. Sedation with general anesthesia (GA) is often used to promote compliance, reduce motion, and alleviate anxiety. The use of GA for MRI scans is costly in terms of time, personnel, and medications. In addition, prominent risks are associated with anesthesia exposure in patients with complex medical conditions. Successful behavioral interventions have been implemented in clinical research settings to promote scan success and compliance...
December 19, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29246332/parent-recommendations-to-enhance-enrollment-in-multidisciplinary-clinical-care-for-pediatric-weight-management
#6
Arnaldo J Perez, Maryam Kebbe, Nicholas L Holt, Rebecca Gokiert, Jean-Pierre Chanoine, Laurent Legault, Katherine M Morrison, Arya M Sharma, Geoff D C Ball
OBJECTIVE: To explore parents' recommendations to enhance enrollment in multidisciplinary clinical care for managing pediatric obesity. STUDY DESIGN: Data for this interpretative description study were collected through individual, semistructured interviews that were audiorecorded, transcribed verbatim, and analyzed thematically. Parents (n = 79) were recruited from 4 multidisciplinary weight management clinics in Canada located in Edmonton, Hamilton, Montreal, and Vancouver...
January 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29222741/exploratory-study-of-barriers-to-successful-office-contacts-for-attention-deficit-hyperactivity-disorder
#7
Jayde T Hooven, Benjamin N Fogel, James G Waxmonsky, Deepa L Sekhar
The American Academy of Pediatrics published attention deficit hyperactivity disorder (ADHD) guidelines, but significant variability exists in care. This exploratory study aimed to understand barriers to compliance with primary care office contacts for ADHD medication management. The study was conducted at a single academic medical center via retrospective chart review between 6/1/15 and 5/31/16 in combination with telephone interviews. Participants included 306 children 6-12 years old with an ADHD-related ICD-9/ICD-10 diagnosis...
December 8, 2017: Attention Deficit and Hyperactivity Disorders
https://www.readbyqxmd.com/read/29217964/sit-down-and-play-a-preventive-primary-care-based-program-to-enhance-parenting-practices
#8
Reshma Shah, Daniela DeFrino, Yoonsang Kim, Marc Atkins
The primary care office offers an ideal setting to encourage parenting behaviors that promote early childhood development. We conducted a pilot study to establish feasibility and acceptability of Sit Down and Play (SDP), a brief primary care-based program to facilitate positive parenting behaviors through take-home play activities. A prospective 1-month study was conducted in an urban primary care clinic. SDP was administered to 30 caregivers of 6-12 month old children while they waited for their well-child appointment...
February 2017: Journal of Child and Family Studies
https://www.readbyqxmd.com/read/29215904/practice-procedures-in-models-of-primary-care-collaboration-for-children-with-adhd
#9
Jessica A Moore, Kathryn Karch, Valeriia Sherina, Aubree Guiffre, Sandra Jee, Lynn C Garfunkel
INTRODUCTION: With nationwide movement toward an integrated medical home, evidence to support, compare, and specify effective models for collaboration between primary care and behavioral health professionals is essential. This study compared 2 models of primary care with behavioral health integration on American Academy of Pediatrics guideline adherence for attention-deficit/hyperactivity disorder (ADHD) assessment and treatment. METHOD: We conducted a retrospective chart review of a random sample of children aged 6-13 years, seen for ADHD services in 2 primary care offices, 1 fully integrated model and 1 co-located service only model, comparing ADHD assessment and treatment practices...
December 7, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/29193588/long-term-evidence-that-a-pediatric-oncology-mentorship-program-for-young-investigators-is-feasible-and-beneficial-in-the-cooperative-group-setting-a-report-from-the-children-s-oncology-group
#10
Adam J Esbenshade, Christopher R Pierson, Amanda L Thompson, Damon Reed, Abha Gupta, Adam Levy, Lisa S Kahalley, Paul Harker-Murray, Reuven Schore, Jodi A Muscal, Leanne Embry, Kelly Maloney, Terzah Horton, Patrick Zweidler-Mckay, Girish Dhall
BACKGROUND: Mentorship of junior faculty is an integral component of career development. The Children's Oncology Group (COG) Young Investigator (YI) Committee designed a mentorship program in 2004 whose purpose was to pair YIs (faculty ≤10 years of first academic appointment) with a senior mentor to assist with career development and involvement in COG research activities. This study reports on the committee's ability to achieve these goals. PROCEDURE: An online survey was sent to YIs who were registered with the program from 2004 to2015, assessing three major domains: (1) overall experience with the mentor pairing, (2) satisfaction with the program, and (3) academic accomplishments of the mentees...
November 28, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29175854/transportation-characteristics-associated-with-non-arrivals-to-paediatric-clinic-appointments-a-retrospective-analysis-of-51-580-scheduled-visits
#11
David J Wallace, Kristin N Ray, Abbye Degan, Kristen Kurland, Derek C Angus, Ana Malinow
BACKGROUND: Prior work has not studied the effects of transportation accessibility and patient factors on clinic non-arrival. OBJECTIVES: Our objectives were: (1) to evaluate transportation characteristics and patient factors associated with clinic non-arrival, (2) to evaluate the comparability of bus and car drive time estimates, and (3) to evaluate the combined effects of transportation accessibility and income on scheduled appointment non-arrival. METHODS: We queried electronic administrative records at an urban general pediatrics clinic...
November 24, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29173105/economic-evaluation-of-teledentistry-in-cleft-lip-and-palate-patients
#12
Jonathan Teoh, Arthur Hsueh, Rodrigo Mariño, David Manton, Kerrod Hallett
OBJECTIVE: To assess the use of Teledentistry (TD) in delivering specialist dental services at the Royal Children's Hospital (RCH) for rural and regional patients and to conduct an economic evaluation by building a decision model to estimate the costs and effectiveness of Teledental consultations compared with standard consultations at the RCH. METHODS: A model-based analysis was conducted to determine the potential costs of implementing TD at the RCH. The outcome measure was timely consultations (whether the patient presented within an appropriate time according to the recommended schedule)...
November 27, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29171167/a-clinical-study-comparing-digital-radiography-and-near-infrared-transillumination-in-caries-detection
#13
Stephen C Berg, Jonathan Miles Stahl, Wen Lien, Casey M Slack, Kraig S Vandewalle
OBJECTIVE: The purpose of this study was to compare the effectiveness of detecting proximal carious lesions utilizing a new near-infrared transillumination (NIRTI) system (CariVu, Dexis) to traditional digital bitewing radiography (BWXR). MATERIALS AND METHODS: Thirty patients received four posterior BWXRs and all premolars and molars were individually imaged with the NIRTI device. Sixty-seven proximal carious lesions were classified based on their depth into enamel or dentin for both BWXR and NIRTI images...
November 24, 2017: Journal of Esthetic and Restorative Dentistry
https://www.readbyqxmd.com/read/29162216/treatment-regimens-by-pediatric-nephrologists-in-children-with-congenital-nephrogenic-diabetes-insipidus-a-mwpnc-study%C3%A2
#14
Cynthia D'Alessandri-Silva, Melinda Carpenter, John D Mahan
BACKGROUND: Congenital nephrogenic diabetes insipidus (NDI) is a rare genetic disorder affecting urinary concentration. Clinicians have varied medication regimens as well as nutritional plan approaches for these children. MATERIALS AND METHODS: An electronic survey was distributed to member pediatric nephrologists of the Midwest Pediatric Nephrology Consortium via email (n = 179). Questions included types of drugs prescribed, factors contributing to drug choice, common drug combinations given, and dietary/failure to thrive interventions used...
November 22, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29109314/a-cross-sectional-study-to-assess-the-perception-of-psychosocial-elements-among-pediatric-patients-visiting-dental-clinics
#15
Ashish Bhalla, U B Rajasekaran, Madhavi Singh, Manish Goutam, Nikhil Grover, Ashok Galav
INTRODUCTION: Children with high dental fear and perception usually encounter high prevalence of dental caries. Data showed that individuals with dental fear will probably defer dental appointments which may result in the formation of a setup of an endless loop of dental fear. Present study was aimed to assess different psycho-social parameters among pediatric patients visiting dental clinics. MATERIALS AND METHODS: In the present cross-sectional study, the data of 200 schoolchildren were collected and analyzed by means of a questionnaire...
November 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/29094862/access-to-primary-care-and-subspecialty-care-after-positive-cystic-fibrosis-newborn-screening
#16
Katelyn Parker-McGill, Marjorie Rosenberg, Philip Farrell
PROBLEM CONSIDERED: Accessibility by telephone to cystic fibrosis (CF) centers for a diagnostic sweat test appointment from a parental perspective—which can be stressful—compared to experience in contacting a general pediatrics practice in the same area. METHODS: We called each CF center and affiliate twice, plus a sample of multiphysician general pediatrics practices selected from yellowpages.com after being matched by area and ZIP codes to 50 randomly selected CF centers, including Wisconsin’s 2 nationally accredited centers...
December 2016: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29056227/intravenous-regional-anaesthesia-bier-s-block-for-pediatric-forearm-fractures-in-a-pediatric-emergency-department-experience-from-2003-to-2014
#17
Ivan S Y Chua, S L Chong, Gene Y K Ong
STUDY OBJECTIVES: To evaluate the efficacy (length of stay in the emergency department and failure rate of Bier's block) and safety profile (death and major complications) of Bier's block in its use for manipulation and reduction of paediatric forearm fractures. METHODS: This is a retrospective cohort study of pediatric patients in KKWomen's and Children's Hospital Children's Emergency Department with forearm fractures between Jan 2003 and Dec 2014 who underwent manipulation and reduction using Bier's block...
October 16, 2017: Injury
https://www.readbyqxmd.com/read/29049087/raising-mean-arterial-pressure-alone-restores-20-of-intraoperative-neuromonitoring-losses
#18
Joshua Yang, David L Skaggs, Priscella Chan, Suken A Shah, Michael G Vitale, Geraldine Neiss, Nicholas Feinberg, Lindsay M Andras
STUDY DESIGN: Multicenter prospective. OBJECTIVE: To assess the effect of intraoperative interventions in restoring intraoperative neuromonitoring (IONM) signals in pediatric spine surgery. SUMMARY OF BACKGROUND DATA: No prior studies have prospectively examined the rate of return of IONM signals by increasing blood pressure (BP) alone. METHODS: Patients undergoing posterior spinal deformity surgery were enrolled at their preoperative appointment...
October 18, 2017: Spine
https://www.readbyqxmd.com/read/29043246/follow-up-of-mothers-with-suspected-postpartum-depression-from-pediatrics-clinics
#19
Nerissa S Bauer, Susan Ofner, Amy Pottenger, Aaron E Carroll, Stephen M Downs
PURPOSE: Pediatric providers are increasingly screening for postpartum depression (PD), yet, it is unknown how often mothers comply with recommendations to seek treatment. The objectives were to describe the rate at which mothers with suspected PD seek treatment and explore factors that predict help-seeking behavior. DESIGN AND METHODS: Mothers were recruited from four pediatric clinics after identification using the Child Health Improvement through Computer Automation (CHICA) system...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29027070/assessment-of-current-genetic-counselor-practices-in-post-visit-written-communications-to-patients
#20
Emily VandenBoom, Angela M Trepanier, Erin P Carmany
Providing patients with post-visit written communication (PVWC) is a long-standing component of genetic counseling. However the depiction of this practice in today's clinical landscape is limited. To better describe this practice, we surveyed practicing clinical genetic counselors to ask if they send post-visit communications to patients and if so, what are the types, the average length, and the average time spent writing. They were also asked the perceived purpose of providing PVWC, if/how the practice has changed over time, and factors influencing the practice...
October 12, 2017: Journal of Genetic Counseling
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